Disposable wet compresses

ABSTRACT

A disposable dermatological compress for the application of aqueous solutions to the skin to achieve evaporative cooling includes a body of water-permeable material constructed as a multi-layer device. An inner layer of smooth sheeting is directly applied to the skin. An intermediate layer of water-absorbing material functions as a reservoir to retain a large quantity of solution. An outer evaporation layer receives the solutions from the reservoir for evaporation. The evaporation layer has a surface area which is several times larger than the area defined by the outer boundaries of the unit to serve as an efficient evaporator.

United States Patent Fleischmajer 1451 July 4,1972

[54] DISPOSABLE WET COMPRESSES [72] Inventor: Raul Fleischmajer, 121Broome Lane,

Merion',.Pa. 19066 [22] Filed: Aug. 6, 1969 [21] App]. No.: 849,293

[52] U.S.Cl

51 1111.0. ..A61I7/l0 [58] FieldofSearch ..l28/155,l56,296,268,68.1,

[56] References Cited UNITED STATES PATENTS 3,122,140 2/1964 Crowe"128/156 2,785,677 3/1957 Stumpf "128/156 2,715,315 8/1955 Giardini......128/38l UX 2,379,657 7/1945' Ryberg 128/268 2,911,973 11/1959 Chieffo..128/265 3,399,672 9/1968 Crowe et al.. .....l28/268 3,468,311 9/1969Gallagher ..128/296 3,457,919 7/1969 Harbard ..l28/156 FOREIGN PATENTSOR APPLICATIONS 776,408 6/1957 Great Britain... .....l28/l56 1,030,0133/1953 France ..128/156 827,861 2/1938 France ..128/l56 PrimaryExaminer-Robert W. Michell Auo rmzy Morton C. Jacobs 571 ABSTRACT Adisposable dermatological compress for the application of aqueoussolutions to the skin to achieve evaporative cooling includes a body ofwater-penneable material constructed as a multi-layer device. An innerlayer of smooth sheeting is directly applied to the skin. Anintermediate layer of water-absorbing material functions as a reservoirto retain a large quantity of solution. An outer evaporation layerreceives the solutions from the reservoir for evaporation. Theevaporation layer has a surface area which is several times larger thanthe area defined by the outer boundaries of the unit to serve as anefficient evaporator.

7 Claims, 1 Drawing Figure PATENTEDJUL 4 m2 INVENTOR.

RAUL FLEESCHMAJEB BY 5 ATTORNEY 1 DISPOSABLE WET COMPRESSES BACKGROUNDOF THE INVENTION compresses Another object is to provide a disposableopen wet comi press which is eflective for evaporative cooling.

Wet compresses or dressings, it is generally agreed,

represent one of the most effective modalities for the treatment of skindisorders. See, for example, Dermatology, Diagnosis and Treatment," bySulzberger, M. B., Wolf, F., and Witten, V. B., published by The YearBook Pub., Inc., Chicago, Illinois, 1961, pp. 44-46; and Dermatology, byPillsbury, D. M., Shelley, W. B., and Kligman, A. M., published by W. B.Saunders Co., Philadelphia, Pa., 1957, p. 315. The latter states: In thepresence of erythematous crusted exudative lesions, wet dressings may bethe only form of treatment which is tolerated. It is often the mostsoothing of all the topical measures."

Another object is to provide a disposable wet compress which provides alarge storage of liquid solutions.

Another object is to provide a disposable wet compress which iseffective to absorb exudates from the skin.

Another object is to provide a disposable wet compress which may beconstructed in various sizes and shapes and which would enablestandardization of medical procedures.

In accordance with one embodiment of the invention, a disposabledermatological wet compress is constructed as a multi-layer device. Aninner layer of porous, smooth sheeting is directly applied to the skin;it passes solutions and exudates The following properties of wetcompresses have been recognized: They are the most effective cleansingagents for the removal of debris, adherent crusts, serum, etc., and theypromote draining of abscesses, infected ulcers, and infected wounds.Their wetting properties induce maceration and thus have an effectivekeratolytic action. They are vehicles for local application of heat orcold, and they are eflective anti-inflammatory agents, through thecooling efiect achieved by allowing continuous evaporation of water.They prevent rapid changes of temperature at the skin surface, which mayhave beneficial anti-pruritic and analgesic effects. They promoteepithelization by providing a moist environment. They have a dryingeffect which can be further enhanced by the addition of certaincompounds (sulphur, aluminum sub-acetate, etc.). They open and dryblisters, and they protect the skin against noxious physical andchemical environmental agents. I

Wet dressings are widely used by dermatologists. There are two methodsof application: (l) open wet dressings and (2) closed wet dressings. Theopen wet dressings have the advantage of allowing free evaporation whichresults in a cooling effect; for this reason, it is generally agreed,open wet dressings are the treatment of choice for acute dermatoses. Onthe other hand, closed wet dressings promote more'maceration, buthaveless cooling effect. I-Iot closed dressings are frequently used bysurgeons to drain abscesses and infected wounds.

Despite the widespread use of wet dressings by dermatologists andsurgeons, there has been no substantial improvement in theirconstruction or in the methods of application. Moreover, the use of wetdressings has never been standardized, so that the mode of applicationis left to the ingenuity and improvisation of the physician, nurse orpatient. At present no such dressings are commercially available for thespecific use as compresses. A review of treatment chapters of severaldennatologic textbooks discloses the following items as being proper foruse as wet dressings: unstarched sheeting, napkin, pillow case, whiteshirting or turkish towels. Most authors suggest using a generous numberof cloth sheets although none have specifically determined what shouldbe the ideal thickness of the dressing. The use of household materialscould be expensive and may carry with them dirt and gems, since very fewpatients will attempt to boil these cloths. Furthermore, subsequentutilization of these materials by the patient or relative may be asource of dissemination of infection. With open dressings (see Pillsburyet al book, cited above) frequent changes of a dressing are necessarydue to rapid drying, which tends to complicate the problems.

A disposable wet dressing, scientifically designed, would be a usefuladdition to the therapeutic armamentarium available to the physician,would provide a reliable and simple device for the patient, and would behelpful in hospitals due to the time-labor saving factor and economy.

SUMMARY OF THE INVENTION is disposable.

respectively to and from the skin, and with materials like rayon orapertured polyethylene it does not tend to adhere thereto. Anintermediate layer of water absorbing material that absorbs and retainsas a reservoir a large quantity of aqueous solution is assembled betweenthe inner layer and an .outer layer. The latter is an evaporation layerand is adjacent the reservoir layer to receive solutions therefrom forevaporation. These layers have corresponding shapes and dimensions sothat they are assembled together in a unitary construction with thereservoir layer passing skin exudates to the outer layer for absorption.The outer layer has an evaporation surface area substantially greaterthan the surface area in contact with the skin so that efficient coolingof the covered skin is achieved.

BRIEF DESCRIPTION OF THE DRAWING The foregoing and other objects of thisinvention, the various features thereof, as well as the inventionitself, may be more fully understood from the following description whenread together with the accompanying drawing.

The drawing is a view in perspective, partly in section, of amulti-layer wet compress embodyingthis invention.

DESCRIPTION OF PREFERRED AND OTHER EMBODIMENTS The wet-compressembodiment illustrated in the drawing includes a three-layer unit 10constructed in a unitary assembly. The center layer 12 serves as areservoir of water or of various aqueous solutions, which are passed tothe lower and upper layers 14 and 16, respectively. The lower layer 14is applied directly to the skin and should have a non-adherent innersurface 18 and also should resist tearing or shedding. The

upper layer 16 is constructed with a large surface area for efficientand rapid evaporation of the water received from the reservoir so as tocool the compress and the covered skin. A textured outer surface 20provides an evaporation area that is very much greater than the area ofthe inner surface 18 in contact with the skin.

Various inexpensive materials are available for constructing theillustrated compress. The lower layer 14 may be made of an aperturedsheet of polyethylene, which presents a smooth inner surface 18 thatwould not adhere to or irritate the skin or ulcerated areas thereof. Theapertures are effective to pass the aqueous solution to the skin and pusand other exudates from the skin to the intermediate layer 12. Any otherpermeable non-adherent material may be used for this layer, including anon-woven polypropylene with a microscopic porosity, a

highly absorbent rayon, and cellulose such as that used in facialtissues. This layer may be quite thin, for example, about 60 to microns.

The reservoir layer may be made of an open cell foam material such aspolyurethane, rubber or the like; non-woven cellulose or a celluloseacetate batting may also be used. This layer is the thickest one (e. g.,0.2 to 2 millimeters), and serves to add strength to the overall unit sothat it resists tearing; it is sufiiciently flexible, especially whenwet, to permit the unit to conform to the limb or body portion to whichit is applied. As the evaporation of water occurs, there tends to be adrawing or attraction of pus from the skin; the open or continuouscellular character of the reservoir material enables this action andalso transmits the exudates to the upper layer 16 where they may lodgeand be absorbed.

The upper layer 16 may be fabricated of highly absorbent cellulose fibersuch as paper, and may also be quite thin (e. g., 60-100 microns). Thislayer is constructed so that the outer layer 20 has a surfaceevaporation area which is preferably several (e. g. 3 to 5) times largerthan the surface area of the compress applied to the skin; for a flatcompress, that area is the planar area defined by the outer boundariesof the unit. For curved skin surfaces, the evaporation surface is alsopreferably larger. Corrugated paper is a suitable textured material fordeveloping a large evaporation surface; other such textures in the formof domes or cubical shapes arranged in various regular or irregularpatterns may be employed. Each segment of the permeable layer 20 islarger in area than the counterpart segment of the reservoir andfunctions efficiently as an evaporator. The paper is also effective asan absorber of exudates transmitted from the skin.

Though rather thin, a polyurethane foam in reservoir layer 12 iseffective to store a large quantity of water, very much greater than athick (or thin) mass of cotton cloth such as shirting fabric. Forexample, a rectangular mass of foam measuring about 3.7 by 6.0centimeters and 0.2 mm. thick has a water capacity of more thanthree-fourths of a milliliter, which is three times (and more) thecapacity of a similar rectangular mass of thick (and thin) cotton cloth.Where the foam is covered with relatively untextured paper, the rate ofevaporation, and thus of cooling, is about the same as from the cloth.With a textured outer surface, the cooling is more rapid and effective.The compress of this invention stays wet over a single application for amuch longer period (twice as long or longer over a period of hours),which is most desirable to avoid disturbing the affected skin area. Adermatological compress having a thicker reservoir will store a largerquantity of water, so that hours of effective cooling by evaporation canbe provided with a single convenient application.

This disposable compress may be pre-soaked with various aqueous (oralcoholic) solutions that are suitable for dermatological purposes. Thewet compresses may be hermetically packaged in vapor-tight containerssuch as aluminum or cellophane bags, so that they may be stored inhospital or home, or carried in a purse or pocket, and be immediatelyavailable under various conditions and in accurately measured astringentor antiseptic aqueous (or alcohol) solutions, such as the following:

a. 0.9 percent sodium chloride, with or without the following individualor combined antibiotics: Polymyxin B sulfate 5000 u/ml Hexachlorophene(alcohol solution) Bacitracin USP 400 u/ml Neomycin Sulfate USP 5 mg/mlb. Aluminum acetate solution (USPXV) 1:15 to 1:30

c. Aluminum subacetate (USPXV) 1:20 to 1:40

d. Boric acid, 2-3 percent e. Vleminckx solution (liquor calcissulfuratae) according to NEX f. Urea 20 percent g. Proteolytic enzymesfor debridement (trypsin, pronase). With distilled or deionized waterused in the preparation of all solutions, the precipitation of saltspresent in tap water is avoided.

Dry disposable compresses can be dispensed to patients with anadditional cellophane envelope containing the active medication and withinstructions as to the volume of water necessary to dissolve the activeingredients in order to obtain the proper concentration. The envelopeitself (or other container) may have measure markings to indicate theamount of water to achieve the right concentration of the solution. Thereservoir layer 12 can be impregnated with active medications in apowder state such as potassium permanganate, aluminum acetate orsubacetate. Since the water retaining capacity of the dressing materials(particularly that of the reservoir) is known, the amount of activemedications that are used is such as to obtain a substantially accurateconcentration (0.05 to 0.02 percent for aluminum acetate; 1:8.000 forpotassium permanganate). For example, a dermatologic compress ofsuitable size (e. g. 20 X 20 cm, with a reservoir layer having a surfacearea of 400 cm and a thickness of about 0.2 mm.) retains 15 ml of waterand requires 3 mg of aluminum acetate to obtain a concentration of 0.02percent. To increase the water retention of the reservoir, glycerin maybe added.

The unit is constructed in rectangular shapes of any suitable size forapplication to various portions of the body. Long strips of dressing maybe packaged in rolls and any size may be cut off as desired. Thedressing may also be fabricated in tubular, stocking or glove, cap ormask and other irregular shapes for application to particular portionsof the body. Any suitable interconnection or bonding of the layers maybe used that maintains the aforementioned permeable communicationbetween layers for water and exudates. The edges of the unit may besecured together by placing them in registry and crimping or heatsealing, or by forming the upper and lower layers somewhat larger andsealing them to enclose the reservoir. The edges may be enlarged wheredesirable for attachment to the body. The corrugated paper may extendaround the sides of the reservoir layer or those sides may be sealed toprevent passage of water therethrough.

Thus, this invention provides an instrument for standardizingdermatological dressings and procedures. Numerous variables tend to beintroduced in present-day treatments due to improvisations by thephysician, nurse or patient as a result of variations in the thicknessand type of compress materials that are used and their absorbentproperties and cleanliness. The present invention avoids thesevariations and improvisations by providing a dressing that is light inweight, compact in size and resistant to shedding and tearing, and thatis reliable and simple to use and lends itself to standardization. Thiswet compress can be packaged with a combined astringent and antibioticsolution (e. g. from those set forth above) and thereby a compress ofwidespread potential utilization is made available.

The materials and quantities thereof that are employed in the compressare such that the fabricated compress is relatively inexpensive andamenable to mass production techniques. Thus the unit can be fabricatedin quantity and at low cost so that it can be used for but oneapplication and thereafter disposed of. The compress may be heated byplacing a sealed bag containing it in hot water, or in boiling waterwith allowance for cooling to obtain the desired temperature. The unitmay be fabricated in a wide variety of shapes and sizes of surface areafor application to different parts of the body. Generally, the unit willbe lighter in weight than similar size dressings made of cotton fabric,and at the same time will be effective to retain more water and remainwet for a longer period of time, which will tend to prolong thetherapeutic effects and avoid unnecessary re-immersions in aqueoussolutions. These dressings will be clean and may be made sterile, thuspreventing the transfer of dirt or bacteria, as may occur from the useof improvised vehicles such as shirts, napkins and the like. Whentreating an infected area, disposable dressings can be changed with eachapplication, thus avoiding reinfections. The total operation is madesimple and can be carried out by the patient without the help of arelative or a properly trained nurse. The availability of disposable,pre-soaked dressings will represent an important time-saving device forhospital nurses and the patient.

A closed wet dressing can be formed by providing an impermeable outerlayer for the dressing. This impermeable layer prevents evaporation. Animpermeable membrane such as polyethylene can be added to the abovedescribed open dressing, or the dressing itself can be fabricated withan impermeable membrane in place of the outer evaporative layer 20. Withsuch a closed dressing, a substantial simplification is achieved in thata five-step present-day process is replaced by the single step ofapplying a pre-soaked disposable closed dressing to the area inquestion. The present-day technique requires the steps of (a)preparation of the solution, (b) wetting of the dressing, (c)application of the dressing around the afiected area, (d) application ofan impermeable dressing to avoid evaporation, and (e) application of agauze bandage to hold the wet dressing and impermeable sheet. The closeddressing may also be used as a dry dressing for certain dermatologicaltherapy, in which case the intermediate reservoir serves to collectsecretions absorbed through the lower layer.

The three-layer device illustrated in the drawing may be modified invarious ways. Other materials than those described above may beemployed. Also, additional layers may be utilized. For example, one ormore layers of absorbent paper may be provided between the lower layer14 and the reservoir layer 12. Such paper may be desirable for absorbingserum or pus.

Thus a new and improved dermatological compress is provided. It isdisposable and as a wet compress is effective for evaporative cooling. Areservoir is provided which serves to store a large quantity of liquidsolutions. The compress is effective to absorb exudates from the skin.The construction is such that it can be formed in various sizes andshapes, enabling standardization of medical techniques.

What is claimed is:

1. A disposable dermatological compress for the application of water oraqueous or alcoholic solutions to the skin to achieve evaporativecooling comprising:

a body of water permeable material having a portion forming an outersmooth surface for application to the skin without adhering thereto,

another portion formed of absorbent material and having an outerevaporation surface,

and an intermediate reservoir portion in communication with the otherportions over substantially the entire surfaces thereof and of materialcapable of absorbing and retaining a large quantity of aqueous oralcoholic solution,

said evaporation surface having at least one projecting surface forevaporation and of area substantially greater than the area of saidouter smooth surface, so that efficient cooling of the covered skinarea'is achieved.

2. A disposable dermatological compress as recited in claim 1 wherein:

said smooth surface portion includes a layer of porous sheeting; andsaid evaporation surface portion includes a layer of porous materialhaving a textured surface for evaporation.

3. A disposable dermatological compress as recited in claim 2 whereinsaid reservoirmaterial passes exudates from the skin to said evaporationsurface layer for absorption thereby.

4. A disposable dermatological compress as recited in claim 3 whereinsaid layers have generally similar shapes and dimensions of theperipheral boundaries thereof and are assembled together in a unitaryconstruction.

5. A composite package comprising:

a container of non-absorptive impermeable material; and

packaged therein a disposable dennatolo'gical compress for theapplication of water and aqueous solutions to the skin to achieveevaporative cooling; said compress including:

a body of water permeable material having a portion forming an outersmooth surface for application to the skin without adhering thereto,

another portion forming an outer evaporation surface, and anintermediate reservoir portion in communication with the other portionsover substantially the entire surfaces thereof and of material capableof absorbing and retaining a large quantity of aqueous solution,

said evaporation surface portion being formed of material of sufficientabsorbency so that aqueous solution would tend to flow to saidevaporation portion from said reservoir portion and having at least oneprojection to provide an area for evaporation substantially greater thanthe area of said smooth surface so that eflicient cooling of the coveredskin area is achieved,

, andan asm'ngent dermatological solution retained in said reservoirrtion. 6. A disposa le dermatological compress for the application ofwater or aqueous or alcoholic solutions to the skin to achieveevaporative cooling comprising:

a body of water permeable material having a portion forming an outersmooth surface for application to the skin without adhering thereto,

another portion forming an outer evaporation surface, and anintermediate reservoir portion in communication with the other portionsover substantially the entire surfaces thereof and of material capableof absorbing and retaining a large quantity of aqueous or alcoholicsolution,

said evaporation surface portion being formed of material of sufficientabsorbency so that said solution would tend to flow to said evaporationportion from said reservoir portion and having projections to provide anarea for evaporation substantially greater than the area of said outersmooth surface, so that efiicient cooling of the covered skin area isachieved.

7. A disposable dermatological compress for the application of water oraqueous or alcoholic solutions to the skin to achieve evaporativecooling as recited in claim 6, wherein said reservoir portion isimpregnated with an active medication in powdered state for producing anastringent dermatological solution.

2. A disposable dermatological compress as recited in claim 1 wherein:said smooth surface portion includes a layer of porous sheeting; andsaid evaporation surface portion includes a layer of porous materialhaving a textured surface for evaporation.
 3. A disposabledermatological compress as recited in claim 2 wherein said reservoirmaterial passes exudates from the skin to said evaporation surface layerfor absorption thereby.
 4. A disposable dermatological compress asrecited in claim 3 wherein said layers have generally similar shapes anddimensions of the peripheral boundaries thereof and are assembledtogether in a unitary construction.
 5. A composite package comprising: acontainer of non-absorptive impermeable material; and packaged therein adisposable dermatological compress for the application of water andaqueous solutions to the skin to achieve evaporative cooling; saidcompress including: a body of water permeable material having a portionforming an outer smooth surface for application to the skin withoutadhering thereto, another portion forming an outer evaporation surface,and an intermediate reservoir portion in communication with the otherportions over substantially the entire surfaces thereof and of materialcapable of absorbing and retaining a large quantity of aqueous solution,said evaporation surface portion being formed of material of sufficientabsorbency so that aqueous solution would tend to flow to saidevaporation portion from said reservoir portion and having at least oneprojection to provide an area for evaporation substantially greater thanthe area of said smooth surface so that efficient cooling of the coveredskin area is achieved, and an astringent dermatological solutionretained in said reservoir portion.
 6. A disposable dermatologicalcompress for the application of water or aqueous or alcoholic solutionsto the skin to achieve evaporative cooling comprising: a body of waterpermeable material having a portion forming an outer smooth surface forapplication to the skin without adhering thereto, another portionforming an outer evaporation surface, and an intermediate reservoirportion in communication with the other portions over substantially theentire surfaces thereof and of material capable of absorbing andretaining a large quantity of aqueous or alcoholic solution, saidevaporation surface portion being formed of material of sufficientabsorbency so that said solution would tend to flow to said evaporationportion from said reservoir portion and having projections to provide anarea for evaporation substantially greater than the area of said outersmooth surface, so that efficient cooling of the covered skin area isachieved.
 7. A disposable dermatological compress for the application ofwater or aqueous or alcoholic solutions to the skin to achieveevaporative cooling as recited in claim 6, wherein said reservoirportion is impregnated with an active medication in powdered state forproducing an astringent dermatological solution.